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Yearly Archives: 2016

Factors Affecting Return To Work After Injury Or Illness:
Best Evidence Synthesis of Systematic Reviews

By |September 15, 2016|Return To Work|

Factors Affecting Return To Work After Injury Or Illness: Best Evidence Synthesis of Systematic Reviews

The Chiro.Org Blog

SOURCE:   Chiropractic & Manual Therapies 2016 (Sep 8)

Carol Cancelliere, James Donovan,
Mette Jensen Stochkendahl, Melissa Biscardi,
Carlo Ammendolia, Corrie Myburgh and J. David Cassidy

Institute of Health Policy,
Management and Evaluation,
Dalla Lana School of Public Health,
University of Toronto,
Toronto, Ontario Canada

BACKGROUND:   Work disability is a major personal, financial and public health burden. Predicting future work success is a major focus of research.

OBJECTIVES:   To identify common prognostic factors for return-to-work across different health and injury conditions and to describe their association with return-to-work outcomes.

METHODS:   Medline, Embase, PsychINFO, Cinahl, and Cochrane Database of Systematic Reviews and the grey literature were searched from January 1, 2004 to September 1, 2013. Systematic reviews addressing return-to-work in various conditions and injuries were selected. Eligible studies were critically appraised using the Scottish Intercollegiate Guidelines Network criteria to identify low risk of bias reviews.

RESULTS:   Of the 36,193 titles screened and the 94 eligible studies reviewed, 56 systematic reviews were accepted as low risk of bias. Over half of these focused on musculoskeletal disorders, which were primarily spine related (e.g., neck and low back pain). The other half of studies assessed workers with mental health or cardiovascular conditions, stroke, cancer, multiple sclerosis or other non-specified health conditions. Many factors have been assessed, but few consistently across conditions. Common factors associated with positive return-to-work outcomes were higher education and socioeconomic status, higher self-efficacy and optimistic expectations for recovery and return-to-work, lower severity of the injury/illness, return-to-work coordination, and multidisciplinary interventions that include the workplace and stakeholders. Common factors associated with negative return-to-work outcomes were older age, being female, higher pain or disability, depression, higher physical work demands, previous sick leave and unemployment, and activity limitations.

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Management of Mild Traumatic Brain Injury Symptoms in a 31-Year-Old Woman Using Cervical Manipulation and Acupuncture

By |September 13, 2016|Acupuncture|

Management of Mild Traumatic Brain Injury Symptoms in a 31-Year-Old Woman

Using Cervical Manipulation and Acupuncture: A Case Report

The Chiro.Org Blog

SOURCE:   J Chiropractic Medicine 2015 (Sep); 14 (3): 220–224

Danielle M. Gergen, DC

Oxboro Family Chiropractic,
Bloomington, MN.

OBJECTIVE:   The objective was to describe chiropractic and acupuncture care of a patient with acute mild traumatic brain injury (mTBI) symptoms.

CLINICAL FEATURES:   A 31-year-old woman had acute neck pain, headache, dizziness, nausea, tinnitus, difficulty concentrating, and fatigue following a fall. She was diagnosed at an urgent care facility with mTBI immediately following the fall. Pharmaceutical intervention had been ineffective for her symptoms.

INTERVENTION AND OUTCOME:   The patient was treated with chiropractic adjustments characterized as high velocity, low amplitude thrusts directed to the cervical spine and local acupuncture points in the cervical and cranial regions. The patient received care for a total of 8 visits over 2.5 weeks with resolution of concussive symptoms.

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Visceral Responses to Spinal Manipulation

By |September 10, 2016|Spinal Manipulation, Visceral Disease|

Visceral Responses to Spinal Manipulation

The Chiro.Org Blog

SOURCE:   J Electromyogr Kinesiol. 2012 (Oct); 22 (5): 777–784

Philip Bolton, Brian Budgell

School of Biomedical Sciences & Pharmacy,
Faculty of Health,
University of Newcastle,
Callaghan NSW 2308, Australia.
Philip.Bolton@newcastle.edu.au

While spinal manipulation is widely seen as a reasonable treatment option for biomechanical disorders of the spine, such as neck pain and low back pain, the use of spinal manipulation to treat non-musculoskeletal complaints remains controversial. This controversy is due in part to the perception that there is no robust neurobiological rationale to justify using a biomechanical treatment of the spine to address a disorder of visceral function. This paper therefore looks at the physiological evidence that spinal manipulation can impact visceral function. A structured search was conducted, using PubMed and the Index to Chiropractic Literature, to construct of corpus of primary data studies in healthy human subjects of the effects of spinal manipulation on visceral function. The corpus of literature is not large, and the greatest number of papers concerns cardiovascular function. Authors often attribute visceral effects of spinal manipulation to somato-autonomic reflexes. While this is not unreasonable, little attention is paid to alternative mechanisms such as somato-humoural pathways. Thus, while the literature confirms that mechanical stimulation of the spine modulates some organ functions in some cohorts, a comprehensive neurobiological rationale for this general phenomenon has yet to appear.

 

From the FULL TEXT Article:

Introduction

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Non-musculoskeletal Disorders
and Chiropractic Page

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Intertester Reliability and Diagnostic Validity of the Cervical Flexion-Rotation Test

By |September 8, 2016|Headache|

Intertester Reliability and Diagnostic Validity of the Cervical Flexion-Rotation Test

The Chiro.Org Blog

SOURCE:   J Manipulative Physiol Ther 2008; 31 (4): 293–300

Toby M. Hall, PT, MS, Kim W. Robinson, PT, BSc,
Osamu Fujinawa, PT, PhD, Kiyokazu Akasaka, PT, PhD,
Elizabeth A. Pyne, PT, MT

School of Physiotherapy,
Curtin University of Technology,
Australia.
halltm@netspace.net.au

OBJECTIVE:   This article evaluates reliability and diagnostic validity of the cervical flexion-rotation test (FRT) to discriminate subjects with headache because of C1/2 dysfunction. In addition, this study evaluates agreement between experienced and inexperienced examiners.

METHODS:   These were 2 single blind comparative measurement study designs. In study 1, 2 experienced blinded examiners evaluated the FRT in 10 asymptomatic controls, 20 subjects with cervicogenic headache (CeH) where C1/2 was the primary dysfunctional level, and 10 subjects with CeH but without C1/2 as the primary dysfunctional level. In study 2, 2 inexperienced and 1 experienced blinded examiners evaluated the FRT in 12 subjects with CeH and 12 asymptomatic controls. Examiners were required to state whether the FRT was positive and also to determine range of rotation using a goniometer. An analysis of variance with planned orthogonal comparison, single measure intraclass correlation coefficient (2,1), and Bland-Altman plot were used to analyze FRT range of rotation between the examiners. Sensitivity, specificity, and examiner agreement for test interpretation were analyzed using cross tabulation and kappa.

RESULTS:   In study 1, sensitivity and specificity of the FRT was 90% and 88% with 92% agreement for experienced examiners (P < .001). Overall diagnostic accuracy was 89% (P < .001) and kappa = 0.85. In study 2, for inexperienced examiners, FRT mobility was significantly greater than for experienced examiners, but sensitivity, specificity, agreement, and kappa values were all within clinically acceptable levels.

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Headache and Chiropractic Page

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Chiropractic Identity, Role and Future: A Survey of North American Chiropractic Students

By |September 6, 2016|Expanded Practice, Prescription Rights|

Chiropractic Identity, Role and Future: A Survey of North American Chiropractic Students

The Chiro.Org Blog

SOURCE:   Chiropractic & Manual Therapies 2015 (Feb 2); 23 (1): 4

Jordan A Gliedt, Cheryl Hawk, Michelle Anderson,
Kashif Ahmad, Dinah Bunn, Jerrilyn Cambron,
Brian Gleberzon, John Hart, Anupama Kizhakkeveettil,
Stephen M Perle, Michael Ramcharan,
Stephanie Sullivan, and Liang Zhang

Logan University College of Chiropractic,
1851 Schoettler Rd,
Chesterfield, MO 63017 USA.

BACKGROUND:   The literature pertaining to chiropractic students’ opinions with respect to the desired future status of the chiropractic physician is limited and is an appropriate topic worthy of study. A previous pilot study was performed at a single chiropractic college. This current study is an expansion of this pilot project to collect data from chiropractic students enrolled in colleges throughout North America.

OBJECTIVE:   The purpose of this study is to investigate North American chiropractic students’ opinions concerning professional identity, role and future.

METHODS:   A 23-item cross-sectional electronic questionnaire was developed. A total of 7,455 chiropractic students from 12 North American English-speaking chiropractic colleges were invited to complete the survey. Survey items encompassed demographics, evidence-based practice, chiropractic identity and setting, and scope of practice. Data were collected and descriptive statistical analysis was performed.

RESULTS:   A total of 1,247 (16.7% response rate) questionnaires were electronically submitted. Most respondents agreed (34.8%) or strongly agreed (52.2%) that it is important for chiropractors to be educated in evidence-based practice. A majority agreed (35.6%) or strongly agreed (25.8%) the emphasis of chiropractic intervention is to eliminate vertebral subluxations/vertebral subluxation complexes. A large number of respondents (55.2%) were not in favor of expanding the scope of the chiropractic profession to include prescribing medications with appropriate advanced training. Most respondents estimated that chiropractors should be considered mainstream health care practitioners (69.1%). Several respondents (46.8%) think that chiropractic research should focus on the physiological mechanisms of chiropractic adjustments.

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Prescription Rights and
Expanded Practice Debate Page

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Results of a National Survey and Examination of Mapping the Health Care Policy Landscape for Complementary and Alternative Medicine Professions Using Expert Panels and Literature Analysis

By |September 4, 2016|Complementary and Alternative Medicine|

Results of a National Survey and Examination of Mapping the Health Care Policy Landscape for Complementary and Alternative Medicine Professions Using Expert Panels and Literature Analysis

The Chiro.Org Blog

SOURCE:   J Manipulative Physiol Ther. 2016 (Aug 14) [Epub]

Patricia M. Herman, ND, PhD, Ian D. Coulter, PhD

RAND Health,
Santa Monica, CA.
pherman@rand.org

OBJECTIVES:   The purpose of this project was to examine the policy implications of politically defining complementary and alternative medicine (CAM) professions by their treatment modalities rather than by their full professional scope.

METHODS:   This study used a 2-stage exploratory grounded approach. In stage 1, we identified how CAM is represented (if considered as professions vs modalities) across a purposely sampled diverse set of policy topic domains using exemplars to describe and summarize each. In stage 2 we convened 2 stakeholder panels (12 CAM practitioners and 9 health policymaker representatives), and using the results of stage 1 as a starting point and framing mechanism, we engaged panelists in a discussion of how they each see the dichotomy and its impacts. Our discussion focused on 4 licensed CAM professions: acupuncture and Oriental medicine, chiropractic, naturopathic medicine, and massage.

RESULTS:   Workforce policies affected where and how members of CAM professions could practice. Licensure affected whether a CAM profession was recognized in a state and which modalities were allowed. Complementary and alternative medicine research examined the effectiveness of procedures and modalities and only rarely the effectiveness of care from a particular profession. Treatment guidelines are based on research and also focus on procedures and modalities. Health plan reimbursement policies address which professions are covered and for which procedures/modalities and conditions.

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Alternative Medicine Articles Section

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